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AAFP Board Review Course Questions 2024 Answered
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AAFP Board Review Course Questions 2024 Answered
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AAFP Board Review Course Questions2024 Answered
11 yo male with bilateral posterior heel pain when you passively and fully dorsiflex the
ankles. Better with rest and worse with activity. Which one of the following is the most
likely diagnosis? - ANSWER-Sever's disease
12 month old M for fever, cough, and pulling on left ear. Afebrile, slightly red TM but
won't allow pneumatic otoscopy. Your diagnosis is? - ANSWER-URI, acute otitis media
uncertain
12 yo M with limp for the past 3 days. Antalgic gait, overweight, and painful right hip with
ROM. No trauma. Radiographs are normal. What is your presumptive diagnosis? -
ANSWER-slipped capital femoral epiphysis
12 yo M with right elbow pain and is a pitcher. 3 weeks he has had pain aggravated by
throwing and better with rest. Tenderness of the right medial epicondyle. You conclude
the following. - ANSWER-this is an apophysitis
17 yo with neck swelling for 2-3 weeks, 5lb weight gain, and feeling more tired. Exam
shows diffusely enlarged, smooth, and non-tender thyroid. What initial test would you
order for this patient? - ANSWER-TSH
19 yo at 40 weeks with painful contractions. No prenatal care. Severe headaches for 3
days with 3+ protein on urine, elevated BP and swelling in hands and feet. She has
seizure when you placed IV so which of the following is the most appropriate immediate
course of action? - ANSWER-magnesium sulfate, 4g loading dose IV, followed by a drip
at 2g/hr
19 yo F with intermittent abdominal cramping and bloating, diarrhea, fatigue, and weight
loss. Initially diagnosed with IBS, but now concern for celiac disease. Which one of the
following should be used to establish the diagnosis? - ANSWER-serologic testing
initially, followed by endoscopy if test results are positive
19 yo male admitted with ketoacidosis. Glucose 670, pH 7.12, K+ 6.8, Na+ 130.
Treatment with fluids and IV insulin is initiated and 3 hours later glucose is 220, pH
7.25, K+ 5.1. What is now most appropriate? - ANSWER-change IV fluid to 1/2 normal
saline with dextrose and K+
20 yo college student with 3 year history of cramping, bloating abdominal pain and
better with defecation. Bowel movements are firm and difficult to pass. Denies risk
factors of alarm. Uses soluble fiber daily. Negative family history. Normal physical
,exam. Diagnose IBS. Which ONE of the following would be most appropriate at this
time? - ANSWER-therapeutic trial of lubiprostone
21 yo college student who swallowed a bunch of Tylenol along with drinking alcohol.
Which of the following would be the best course of action - ANSWER-administer
activated charcoal
22 yo G0 woman with 2 days of vaginal discharge. Cervix appears reddened almost
strawberry texture. Generous amount of yellowish, malodorous leukorrhea, but not pus
at the os. Of the following, which is the most likely diagnosis? - ANSWER-trichomonas
vaginalis infection
24 yo F has SVT. You try valsalva, and it doesn't work. Which of the following is the
next best step in treatment? - ANSWER-IV adenosine
24 yo M with 3 day rash that is getting bigger with central clearing. No other symptoms
or bites that he knows of. Went to Martha's Vineyard. In this case, you would treat with -
ANSWER-doxycycline 100mg BID for 10 days
26 yo F with positive urine pregnancy but then BHCG 2500. US shows no gestational
sac in uterus. Has IM methotrexate. 4 days later, BHCG is 3800 and then 7 days later is
4400. Which one the following is the most appropriate next test? - ANSWER-
laparoscopy with salpingectomy
26 yo G2P1 at 30 weeks has severe itching. Had same issue during last pregnancy,
and she had intrahepatic cholestasis of pregnancy. Elevation of which of the following is
most characteristic of this disorder? - ANSWER-bile acids
26yo G3P2 with mild chronic HTN and uncomplicated pregnancy that jus delivered a
baby via vaginal delivery and is having a postpartum hemorrhage. Which one of the
following uterotonic agents is CONTRAINDICATED in the management of this patient's
postpartum hemorrhage? - ANSWER-methylergonovine
3 yo M walking home with mom and cries of pain when elbow is moved and keeping it
to left side. Negative x-rays. Using an evidence-based approach to your patient, what
would be the best treatment? - ANSWER-hyperpronation of the forearm
3 yo M with Hb SS disease and taking penicillin daily. Parents want to know if he should
continue. You should recommend: - ANSWER-Take penicillin V 250mg PO BID until
age 5 at least
31 yo M brought to ED after trauma to leg with blood positive in dipstick, but no blood
seen under microscope. This patient should be admitted for the management of -
ANSWER-rhabdomyolysis
, 32 yo breastfeeding F with redness over right breast and fever of 101F. Redness
started 3 days ago and fever within the past 12 hours. Had c-section 14 days ago and
was in hospital for 7 days after for endomyometritis. Has hard, red, tender, swollen area
over right breast measuring 4 x 6cm with no axillary adenopathy . Which one of the
following would be the most appropriate management option? - ANSWER-clindamycin
32 yo M wants refill of sulfasalazine for ulcerative colitis that has been well controlled,
and he hasn't seen an GI for years. Which one of the following is an appropriate
management plan for this patient? - ANSWER-continue sulfasalazine and arrange for
colonoscopy to screen for colorectal cancer
33 yo F had pap that is negative for intraepithelial neoplasia, positive for HPV but
negative for serotypes 16 and 18. Which one of the following is the most appropriate
management for this patient? - ANSWER-repeat Pap and HPV testing in 12 months
34 yo F with SLE has acute pain, rubber, calor, and swelling of the left knee. No trauma
and is on hydroxychloroquine and prednisone. SLE symptoms are well controlled . The
most likely cause of this patient's knee pain is - ANSWER-infectious arthritis
35 yo M with 3 month history of asymmetric poly arthritis noted in 6 separate joints and
pitting of fingernails along with scaly, silver rash noted on both elbows. Which tx has
been shown to delay further progression of this patient's joint erosion? - ANSWER-
etanercept
35 yo M with parents born in southeast asia, but he was born in the US. No vaccine
records. Has a relative that is positive for Hep B. According to the USPSTF, which one
of the following screening recommendations is appropriate for this patient? - ANSWER-
screen for HBV infection because he is at high risk
36 yo G3P2A1 presents with 14 month history of amenorrhea, hot flashes, and vaginal
dryness. Used to have normal menses. Negative urine pregnancy with normal TSH,
prolactin levels but elevated LH and FSH levels. The most likely diagnosis is: -
ANSWER-primary ovarian insufficiency
38 yo F with Hx of lap cholecystectomy 8 weeks ago. 2+ bilateral pitting ankle edema.
Your choice of an initial diagnostic study would be: - ANSWER-D-dimer
39 yo F with uncontrolled diabetes with 8 day history of thick white vaginal discharge
and vulvar itching. Had tried 7 day OTC for yeast infection, but only did 5 days of it. Has
extensive vulvar erythema, excoriations, and edema with thick, curd-like white
discharge at the introits with the vagina being erythematous. KOH prep shows budding
yeast and hyphae. Which of the following medications would be the most appropriate
treatment for this condition? - ANSWER-Fluconazole 150mg PO in two doses that are
72 hours apart
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